Unintentional Fall-Related Mortality among the Elderly in Serbia: Importance of Death Reporting Quality
-
Konstansa Lazarevic
,
Miodrag Stojanovic
,
Dragan Milic
,
Zana Dolicanin
,
Ljiljana Stosic
,
Sasa Milicevic
,
Dragan Bogdanovic
Abstract
Background: Falls have been one of the leading causes of injury-related deaths among the elderly, having an increasing trend in many countries. We investigated trends of fall-related mortality among people aged ≥65 yr in Serbia.
Methods: Based on official data, we calculated unintentional fall-related mortality rate (MR) from 1998 to 2017, using join point regression analysis to determine annual percentage changes (APC). Starting from 2005, doctors from Serbian Public Health Institute have been controlling the quality of death certificates.
Results: In the 1998-2004 period, MR decreased in men and women aged 65-74 and men aged ≥85 (by -12.4; -13.0; and -15.1% yearly) followed by an upward trend in men and women aged 65-74 (by 76.3 vs.40.2%yearly) from 2004 to 2007 and men aged ≥85 (by 13.7% yearly) from 2004 to 2017. MR decreased among women aged ≥85 (by-9.8% yearly) from 1998 to 2008 and then increased (by 9.0% yearly) from 2008 to 2017. In men and women aged 75-84, an increase of MR (by 7.4 vs.3.1%) was observed during the entire study period. In all age groups, except women aged ≥85, significant negative correlation was found between fall-related deaths and ill-defined and unknown causes of deaths.
Conclusion: Control of death certificates by physicians from the Institute of Public Health led to the better reporting of the increasing trend of fall-related mortality among the elderly. Policy makers must investigate risk factors for fall and then adopt national guidelines for prevention and treatment of fall-related injury.
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26. Ning P, Schwebel DC, Chu H, et al (2019). Changes in reporting for unintentional in-jury deaths, United States of America. Bull World Health Organ, 97(3):190-9.
27. Kharrazi RJ, Nash D, Mielenz TJ (2015). In-creasing Trend of Fatal Falls in Older Adults in the United States, 1992 to 2005: Coding Practice or Reporting Quality? J Am Geriatr Soc, 63(9):1913-7.
28. Vlajinac H, Sipetić-Grujicić S, Janković S, et al (2006). Burden of cancer in Serbia. Croat Med J, 47(1):134-41.
29. Cheng X, Wu Y, Yao J, et al (2016). Mortali-ty from unspecified unintentional injury among individuals aged 65 years and old-er by US state, 1999-2013. Int J Environ Res Public Health, 13(8): E763.
30. Statistical Office of the Republic of Serbia (2018). Demographic Yearbook, 2017. Available from: https://publikacije.stat.gov.rs/G2017/PdfE/G20172022.pdf
31. Ministry of Health of the Republic of Serbia (2014). Results of the National Health Survey in Serbia, 2013. Belgrade: Institute of Public Health of Serbia. Available from: http://www.batut.org.rs/download/publikacije/2013SerbiaHealthSurvey.pdf
32. Penev G, Stankovic B (2018). Widowed per-sons in Serbia: Change in number and general demographic characteristics (1980-2016). Stanovnistvo, 56:83-108 (in Serbian).
33. Joshi A, Rajabali F, Turcotte K, et al (2020). Fall-related deaths among older adults in British Columbia: cause and effect of poli-cy change. Inj Prev, 26:412-6.
2. Terroso M, Rosa N, Marques AT, et al (2014). Physical consequences of falls in the elderly: a literature review from 1995 to 2010. Eur Rev Aging Phys Act, 11:51–9.
3. Florence CS, Bergen G, Atherly A, et al (2018). Medical Costs of Fatal and Nonfa-tal Falls in Older Adults. J Am Geriatr Soc, 66(4):693-8.
4. GBD 2017. Causes of Death Collaborators (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392(10159):1736-88.
5. Turner S, Kisser R, Rogmans W (2015). Falls among older adults in the EU-28: Key facts from the available statistics. European association for injury prevention and safety promo-tion. Amsterdam, Netherlands: Euro Safe. Available from: http://www.eunaapa.org/wp-con-tent/uploads/2015/09/Factsheet_falls-in-older-adults-in-EU.pdf
6. Corporate Authors (2020). Ageing Europe. Looking at the Lives of Older People in the EU. Technical Report. Available from : https://ec.europa.eu/eurostat/documents/3217494/11478057/KS-02-20-655-EN-N.pdf/9b09606c-d4e8-4c33-63d2-3b20d5c19c91?t=1604055531000
7. Burns E, Kakara R (2018). Deaths from fall among Persons Aged ≥65 Years - United States, 2007-2016. MMWR Morb Mortal Wkly Rep, 67(18):509-14.
8. Padrón-Monedero A, Damián J, Pilar Martin M, et al (2017). Mortality trends for acci-dental falls in older people in Spain, 2000-2015. BMC Geriatr, 17(1):276. doi: 10.1186/s12877-017-0670-6
9. Olij BF, Panneman MJM, van Beeck EF, et al (2019). Fall-related healthcare use and mortality among older adults in the Neth-erlands, 1997-2016. Exp Gerontol, 120:95-100
10. Hagiya H, Koyama T, Zamami Y et al (2019). Fall-related mortality trends in older Japa-nese adults aged≥ 65 years: a nationwide observational study. BMJ Open, 9(12):e033462. doi: 10.1136/bmjopen-2019-033462.
11. Haagsma JA, Olij BF, Majdan M, et al (2020). Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017. Inj prev, 26(Supp 1):i67-74.
12. Hu G, Baker SP (2012). An explanation for the recent increase in the fall death rate among older Americans: a subgroup anal-ysis. Public Health Rep, 127(3):275-81.
13. Silvi J (2003). On the estimation of mortality rates for countries of the Americas. Epi-demiol Bull, 24(4):1-5.
14. Lopez AD (2013). Reducing risks to health: what can we learn from the Global Bur-den of Disease 2010 Study? Int J Pub Health, 58(5):645–6.
15. James SL, Lucchesi LR, Bisignano C, et al (2020). The global burden of falls: global, regional and national estimates of mor-bidity and mortality from the Global Bur-den of Disease Study 2017. Inj Prev, 26(Supp 1):i3-i11.
16. WHO (2008). WHO global report on falls prevention in older age? 1st ed. Geneva, Switzerland: World Health Organization. Available from: https://extranet.who.int/agefriendlyworld/wp-content/uploads/2014/06/WHo-Global-report-on-falls-prevention-in-older-age.pdf
17. Penev G (2014). Population ageing trends in Serbia from the beginning of the 21st century and prospects until 2061: Region-al aspect. Zbornik Matice Srpske Za Drustvene Nauke, 148: 687‒700.
18. Rulebook on the procedure of issuance and the form of the death certificate ("Official Gazette of RS", No. 8/05). In Serbian
19. Rulebook on the procedure of issuance and the form of the death certificate ("Official Gazette of RS", No. 25/11, 103/2018). In Serbian
20. Statistical Office of the Republic of Serbia (2011). Population estimates by age and sex, a comparative overview on the mu-nicipality level. Available from: https://data.stat.gov.rs/Home/Result/18010602?languageCode=en-US
21. Kim HJ, Fay MP, Feuer EJ, et al (2000). Per-mutation tests for joinpoint regression with applications to cancer rates. Stat Med, 19 (3): 335-51.
22. EuroSafe (2016) Injuries in the European Union, Summary on injury statistics 2012-2014, Amsterdam. Available from: https://www.eurosafe.eu.com/uploads/inline-files/EuropeSafe_Master_Web_02112016%20%282%29.pdf
23. Stevens JA, Rudd RA (2014). Circumstances and contributing causes of fall deaths among persons aged 65 and older: United States, 2010. J Am Geriatr Soc, 62(3):470-5.
24. Fife D (1987). Injuries and deaths among el-derly persons. Am J Epidemiol, 126:936–941.
25. Betz ME, Kelly SP, Fisher J (2008). Death certificate inaccuracy and underreporting of injury in elderly people. J Am Geriatr Soc, 56(12):2267-72.
26. Ning P, Schwebel DC, Chu H, et al (2019). Changes in reporting for unintentional in-jury deaths, United States of America. Bull World Health Organ, 97(3):190-9.
27. Kharrazi RJ, Nash D, Mielenz TJ (2015). In-creasing Trend of Fatal Falls in Older Adults in the United States, 1992 to 2005: Coding Practice or Reporting Quality? J Am Geriatr Soc, 63(9):1913-7.
28. Vlajinac H, Sipetić-Grujicić S, Janković S, et al (2006). Burden of cancer in Serbia. Croat Med J, 47(1):134-41.
29. Cheng X, Wu Y, Yao J, et al (2016). Mortali-ty from unspecified unintentional injury among individuals aged 65 years and old-er by US state, 1999-2013. Int J Environ Res Public Health, 13(8): E763.
30. Statistical Office of the Republic of Serbia (2018). Demographic Yearbook, 2017. Available from: https://publikacije.stat.gov.rs/G2017/PdfE/G20172022.pdf
31. Ministry of Health of the Republic of Serbia (2014). Results of the National Health Survey in Serbia, 2013. Belgrade: Institute of Public Health of Serbia. Available from: http://www.batut.org.rs/download/publikacije/2013SerbiaHealthSurvey.pdf
32. Penev G, Stankovic B (2018). Widowed per-sons in Serbia: Change in number and general demographic characteristics (1980-2016). Stanovnistvo, 56:83-108 (in Serbian).
33. Joshi A, Rajabali F, Turcotte K, et al (2020). Fall-related deaths among older adults in British Columbia: cause and effect of poli-cy change. Inj Prev, 26:412-6.
| Files | ||
| Issue | Vol 51 No 10 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i10.10982 | |
| Keywords | ||
| Falls Elderly Mortality Serbia | ||
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How to Cite
1.
Lazarevic K, Stojanovic M, Milic D, Dolicanin Z, Stosic L, Milicevic S, Bogdanovic D. Unintentional Fall-Related Mortality among the Elderly in Serbia: Importance of Death Reporting Quality. Iran J Public Health. 2022;51(10):2244-2252.
